Pearl Ventures

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

PEARL VENTURES

Doing business as

PEARL MEDICAL SUPPLY

Practice address

1012 E Cooley Dr Ste N
Colton, CA 92324-3949

Phone

(909) 422-8005

Fax

(909) 824-1080

NPI assigned

Sep 29, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Ofonime Ukpong

Title

Manager

Phone

(909) 422-8005

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PEARL MEDICAL SUPPLY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570406400000",
    "number": "1487746327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 E COOLEY DR STE N",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243949",
            "telephone_number": "909-422-8005",
            "fax_number": "909-824-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 E COOLEY DR STE N",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243949",
            "telephone_number": "909-422-8005",
            "fax_number": "909-824-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL VENTURES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2019-10-07",
        "status": "A",
        "authorized_official_last_name": "UKPONG",
        "authorized_official_first_name": "OFONIME",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "909-422-8005",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME02470F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEARL MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PEARL MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rody Paz Casanova, D.D.S.
• Paz Dental Group Inc
• Paz Dental Group,Inc
• Veronica Paz
• Kadi Lyn Pearce, LVN
• Kamaile Elizabeth Peck
• Jennifer Velasco Pedroza, P.A.
• Kylie Renae Pedroza
• David E Pena
• Diana Pena

• Customized Equipment (DME) in Colton, CA
• Providers in Colton, CA by specialty
• Customized Equipment (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.